<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Qu_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-qu_id" data-rule="required" data-source="qu/index" class="form-control selectpage" name="row[qu_id]" type="text" value="{$row.qu_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Jiedao_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-jiedao_id" data-rule="required" data-source="jiedao/index" class="form-control selectpage" name="row[jiedao_id]" type="text" value="{$row.jiedao_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Village_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-village_id" data-rule="required" data-source="village/index" class="form-control selectpage" name="row[village_id]" type="text" value="{$row.village_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address" class="form-control" name="row[address]" type="text" value="{$row.address|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Taocan_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-taocan_id" data-rule="required" data-source="taocan/index" class="form-control selectpage" data-field="taocan" name="row[taocan_id]" type="text" value="{$row.taocan_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" class="form-control" name="row[name]" type="text" value="{$row.name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" class="form-control" name="row[mobile]" type="text" value="{$row.mobile|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cardid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardid" class="form-control" name="row[cardid]" type="text" value="{$row.cardid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-remark" class="form-control " rows="5" name="row[remark]" cols="50">{$row.remark|htmlentities}</textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Zheng_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-zheng_image" class="form-control" size="50" name="row[zheng_image]" type="text" value="{$row.zheng_image|htmlentities}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-zheng_image" class="btn btn-danger faupload" data-input-id="c-zheng_image" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-zheng_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-zheng_image" class="btn btn-primary fachoose" data-input-id="c-zheng_image" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-zheng_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-zheng_image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Fan_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-fan_image" class="form-control" size="50" name="row[fan_image]" type="text" value="{$row.fan_image|htmlentities}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-fan_image" class="btn btn-danger faupload" data-input-id="c-fan_image" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-fan_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-fan_image" class="btn btn-primary fachoose" data-input-id="c-fan_image" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-fan_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-fan_image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('State')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <div class="radio">
            {foreach name="stateList" item="vo"}
            <label for="row[state]-{$key}"><input id="row[state]-{$key}" name="row[state]" type="radio" value="{$key}" {in name="key" value="$row.state"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Chuli_remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-chuli_remark" class="form-control " rows="5" name="row[chuli_remark]" cols="50">{$row.chuli_remark|htmlentities}</textarea>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
